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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 60-year-old man was admitted for ablation of ventricular tachycardia &#40;VT&#41; following anteroseptal myocardial infarction&#46; Cardiac computed tomography &#40;CT&#41; images were processed with ADAS-VT software &#40;Galgo Medical&#44; Barcelona&#44; Spain&#41;&#46; Two large zones of septal and anteroapical wall thinning were found&#44; separated by a very small zone of thicker wall&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">High-density electroanatomical mapping was performed using CARTO 3 and the PentaRay catheter &#40;Biosense Webster&#44; Diamond Bar&#44; CA&#41;&#46; Local abnormal ventricular activity &#40;LAVA&#41; and late potentials were observed between thinned segments&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Two badly tolerated VTs could be induced&#44; VT1 &#40;right bundle branch block&#44; superior axis&#41; and VT2 &#40;left bundle branch block&#44; inferior axis&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A pace-mapping strategy was pursued&#46; Pace mapping along the area of the 6-10 mm wall thinning zone&#44; between the areas of &#60;6 mm wall thinning&#44; matched both VT morphologies&#44; demonstrating that activation proceeded along the exit or entry parts of the isthmus according to slight changes in the pacing site&#46; VT1 and VT2 shared a common isthmus in the 6-10 mm thickness zone&#44; in opposite directions &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Ablation was performed targeting LAVA&#46; The patient&#39;s VT was eventually non-inducible and there were no recurrences during follow-up&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Integration of magnetic resonance imaging and&#47;or CT scans with electroanatomical maps are associated with better procedural outcomes&#46; Regional myocardial wall thinning correlates with low-voltage zones and abnormal potentials that are critical for the maintenance of VT&#46; Such an approach may help to detect the underlying critical substrate itself and to understand the mechanisms of VT&#44; which should lead to procedural success&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">However&#44; the sensitivity and positive predictive value of CT scan to detect VT isthmuses are not yet optimal&#44; and further studies are also warranted to better define the minimal myocardial thickness able to harbor a VT isthmus&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Image in Cardiology
Analysis of wall thickness to help identify critical isthmuses during ventricular tachycardia ablation
Análise da espessura parietal na identificação de istmos críticos durante a ablação de taquicardia ventricular
Raphaël P. Martins
Autor para correspondência
raphael.martins@chu-rennes.fr

Corresponding author.
, Vincent Galand, Dominique Pavin
Département de Cardiologie et Maladies Vasculaires, CHU de Rennes, Cedex 35033, Rennes, France
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Revista Portuguesa de Cardiologia
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.